Brain Tumours Flashcards
Symptoms of space occupying lesion (SOL)
Progressive focal neurological deficit
Headache (worse in morning/straining)
Seizures
Papilloedema
Primary tumours which metastasise to brain
Lung Breast Kidney Skin (melanoma) Colon (common cancers)
Symptoms of a brain tumour in the frontal lobe.
Weakness
Expressive dysphasia Personality change
Symptoms of a brain tumour in the parietal lobe.
Sensory loss
Neglect
Loss of spatial awareness
Loss of reading and writing ability
Symptoms of a brain tumour in the temporal lobe
Hearing loss
Receptive dysphasia
Memory loss
Symptoms of a brain tumour in the occipital lobe
Visual loss
Symptoms of a brain tumour in the cerebellum.
Dizziness
Nausea
Ataxia
What is the investigation of choice for a suspected brain tumour?
MRI
What brain tumours most commonly affect adults?
5
Astrocytoma Meningioma Oligodendroglioma Schwannoma Pituitary adenoma
What brain tumours most commonly affect children?
Astrocytoma
Medulloblastoma
Craniopharyngioma
What is the most common brain tumour in adults?
Astrocytoma
What is the second most common brain tumour in adults?
Meningioma
What is the most common brain tumour in children?
Astrocytoma
What is the second most common brain tumour in children?
Medullablastoma
What are the names of the 4 graded astrocytic tumours?
Grade I: pilocytic astrocytoma
Grade II: diffuse astrocytoma
Grade III: anaplastic astrocytoma
Grade IV: glioblastoma multiforme
Truly benign astocytoma?
Pilocytic astrocytoma
What are pilocytic astrocytomas composed of?
Hair like tissue (pilo_) Cystic areas (_cysic)
Who tends to develop pilocytic astrocytoma?
Children
Brain tumour commonly presenting with a seizure?
Diffuse astrocytoma (grade II)
may also be oligodendroglioma, but less common
Tumour enhances on contrast study.
What does this suggest?
Malignant
What do anaplastic astrocytoma commonly progress to?
Glioblastoma multiforme
What is the commonest primary brain tumour?
Glioblastoma multiforme
What do glioblastoma multiforme show histologically?
Severe atypia and areas of necrosis and neovascularisation
What are the two types of glioblastoma multiforme and how do they differ
Primary: arise de novo
Secondary: arise from transformation from anaplastic astrosytoma
They are molecularly different
Neurofibromatosis type 2 is associated with which brain tumour?
Meningioma
Vestibular schwannoma
Elderly man with café au lait marks is
- symptomatic
- asymptomatic
What brain tumours is he likely to have for each answer?
What symptoms would he have if he is asymptomatic?
Symptomatic: vestibular schwannoma (sensorineural hearing loss, vertigo)
Asymptomatic: meningioma
How do you treat meningioma?
Conservatively if asymptomatic
If symptoms, excise
Which brain tumour carries the best prognosis?
Do they tend to affect children or adults?
Oligodendroglioma
Adults
What tumour can mimic astrocytoma?
Oligodendroglioma
How do you manage vestibular schwannoma?
Periodic neurological examination/MRI
+
Hearing aid
Where do adult brain tumours generally arise?
Above the tentorium cerebelli
Tumour in midline of cerebellum.
Diagnosis?
Child or adult?
Medulloblastoma
Child
What do medulloblastomas appear like histologically?
Embryonic precursor cells
blast
Child presents with bitemporal hemianopia.
Diagnosis?
Craniopharyngioma
Where do adult brain tumours generally arise?
Below tentorium cerebelli
What is epenyoma?
Tumour of ependymal cells (lining of ventricles) which presents in the brain in children and in the spinal cord in adults
What is haemangioblastoma?
CNS tumour which arises from the vasculature and has endothelial cells in it
Midline tumour in a child with mixed cytology.
Diagnosis?
First step in management?
Pineal tumour
Blood test for blood markers
AFP, b-HCG, PLAP
Midline tumour in child with high
- AFP
- b-HCG
- PLAP.
Diagnosis for each?
AFP: yolk sac tumour
b-HCG: choriocarcinoma
PLAP: germinoma
